Fast-track anesthesia and outcomes in hepatopancreatic cancer surgery: a retrospective analysis.

Aim: To assess the feasibility of a fast-track anesthesia protocol for hepatopancreatobiliary cancer surgery.

Methods: Retrospective analysis of consecutive sample of patients who underwent hepatopancreatic surgery for cancer for a period of 12 months in a high volume cancer center. Blended anesthesia was performed for most patients who were then observed in a recovery room area until achieving a safety score.

Nutritional management of the patient with pancreatic cancer: from the diagnostic and therapeutic pathway to an integrated hospital-territory approach.

Pancreatic cancer is associated to a high risk of malnutrition and neoplastic cachexia even at first diagnosis. Malnutrition is a negative prognostic factor for the outcome of surgery or medical oncology treatments. Despite the good awareness of the problem and the knowledge of the guidelines, the early recognition of malnutrition and its management are still uneven, mainly due to the lack of implementation of standardized and shared protocols and the shortage of dedicated clinical nutritionists and dieticians.

Assessing the learning curve for totally laparoscopic major-complex liver resections: a single hepatobiliary surgeon experience.

Background: Encouraging results have been reported in terms of feasibility, safety, and oncologic, outcomes even for major (≥ 3 segments) or complex for location-specific (right posterior segments) laparoscopic liver resections. Despite this, technically challenging issues and advanced laparoscopic skills required to perform it have limited its use in few highly specialized centers. The aim of this study was to assess the learning curve for major-complex totally laparoscopic liver resections (TLLR) performed by a single HPB surgeon.

Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes.

Background: Standard oncologic liver resections performed on elderly patients (≥70 years old) have been shown to be safe and effective. The aim of this study was to analyze operative and oncologic short-term outcomes of totally laparoscopic liver resections (TLLR) performed on elderly patients for malignancies.

Methods: We performed a retrospective statistical analysis of prospectively recorded data of TLLR performed from October 2008 to February 2012 by a single hepato-pancreato-biliary (HPB) surgeon.

One-stage, totally laparoscopic major hepatectomy and colectomy for colorectal neoplasm with synchronous liver metastasis: safety, feasibility and short-term outcome.

Background: Simultaneous surgery for primary colorectal tumor with synchronous liver metastasis has been showed to be safe and effective. One-stage, totally laparoscopic colorectal and minor liver resections have been reported, but there are no data regarding patients requiring simultaneous major hepatectomies and colorectal surgery. We aimed to evaluate the safety, feasibility and short-term outcomes of a small cohort of highly selected patients treated by 1-stage, totally laparoscopic major hepatectomy and colorectal resection.